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While it’s certainly great news for the hundreds of thousands of poor and middle class people who no longer need to live in fear that a random accident will destroy their finances all because the Republican Governor wanted to be a boob about things, there is a pretty hefty corruption tax attached to the price tag when we use the federal Medicaid money the Republican Way:

Mr. Corbett’s plan, submitted to the federal government in February, would not directly expand the state’s Medicaid program, but would offer federal subsidies to about 500,000 low-income Pennsylvanians to purchase private insurance.

Medicaid is more efficient than private insurance. People on Medicaid get basically the same access to care as people with private insurance, but for lower administrative costs.

Doing this the Republican Way is like running a leaking sack full of the federal Medicaid money down a long gauntlet of private insurance companies, as dudes grab money off the top before it gets to actual patients.

On the administrative side, if we just accept regular Medicaid, we could hire as few as 40 people to administer it. Doing it the Republican Way, we have to hire about 723 new state workers:

Pennsylvania’s ambitious alternative to expanding Medicaid – a private-market initiative that Gov. Corbett says is designed to save money – would require 723 new state workers, about one percent of the current workforce.

The projected number of hires, detailed by state officials, is far higher than most states have needed and surprised some public-policy experts. Many states are adding employees to review applications and confirm eligibility, and to implement all the changes required by federal law. Those new hires typically are in the dozens. New Jersey, for example, said the contractor that coordinates its health benefits hired 38 permanent employees and 62 temps.

“The enrollment system is heavily automated for Medicaid,” said Sara Rosenbaum, a professor of health law and policy at George Washington University. “This is not being done by ladies with shoe boxes and pieces of paper.”

Worst of all, Medicaid beneficiaries earning at more than 100% of the poverty line have pay premiums. The weird work search requirements didn’t make it into the federal proposal, but what you have here is essentially a benefit cut for Medicaid beneficiaries to finance a nice round of pointless grift for hospital corporations and for-profit insurance companies.

No, it is not. If I want to purchase a Tesla but despise Toyota cars, it will NEVER be more efficient for you to take my money and purchase a Toyota on my behalf. I don’t care if the commission is $0 for the Toyota and $5000 for the Tesla. All money spent on that Toyota is wasted.

Likewise, 100% of my money spent on Medicaid is wasted. I do not want to pay for such a program. I do, however, pay for private insurance.

Medicaid is bought of, by and for us, via our democratic republic to care for those who need it. If you have private healthcare, you don’t need it, so we won’t buy it for you. Our system would grind quickly to a halt if we all picked every dime of our expenditures…and it might, if they don’t start better representing our wishes.

For example, I don’t want to send Israel $3B+ per year to blow up Palestine, and $1B to The Ukraine because they are fighting someone over something. But, here I am.